The Senate Appropriations Committee passed measures on Thursday that would repeal two decades-old policies restricting abortion care abroad. One would lift a total ban on abortion coverage for Peace Corps volunteers, and another would permanently repeal the so-called Global Gag Rule that prevents foreign organizations receiving U.S. aid from either funding or advocating for abortion care.

Although Peace Corps volunteers make only about $300 a month, less than the cost of a typical abortion, since 1979 they have been the only people with federal health insurance who cannot receive any funding for abortion care, even in cases of rape, incest, or life endangerment. Most federal abortion coverage bans allow exceptions in those three limited circumstances. A recent report details the harm this policy has caused volunteers, and 97 percent of those volunteers surveyed think the policy should be changed.

“This is a welcome and long overdue step toward fair and equal treatment of women who volunteer for their country in the Peace Corps,” said Debra L. Ness, president of the National Partnership for Women and Families, in a statement about the committee’s action to repeal the restriction. “It would finally give Peace Corps volunteers the same abortion coverage as other women who get their health insurance through the federal government. It’s about time.”

For 30 years, since 1984 when it was first imposed by the Reagan administration, the Global Gag Rule has been alternately rescinded under Democratic administrations and reinstated in Republican administrations. Advocates say that it fails to reduce the number of abortions overseas, defunds some of the best foreign family planning providers, harming women’s health, and prevents foreign agencies from using even their own money for abortion counseling or services.

The amendment to legislatively prevent the reimposition of the Global Gag Rule, sponsored by Sen. Jeanne Shaheen (D-NH), “could mean ending the global gag rule once and for all, 30 years after its inception,” said Cecile Richards, president of Planned Parenthood Federation of America, in a statement. “Imagine that: no more service interruptions, health center closures, or playing political football with women’s health and lives.”

The Senate’s version of the State and Foreign Operations appropriations bill will have to be reconciled with the House’s version. The two chambers have introduced competing amendments to either reinstate or repeal the gag rule over the last several years.

A new report released Monday, coordinated with a lobbying effort on Capitol Hill, says that returning Peace Corps volunteers see a policy denying them abortion coverage under any circumstances as “punitive and unfair” and think it needs to be changed.

UPDATE, May 6, 4:50 p.m.: The Peace Corps Equity Act was officially reintroduced in both the House and Senate on Monday, with 27 bipartisan co-sponsors in the Senate and four co-sponsors in the House so far.

Peace Corps volunteers receive no coverage for abortion care under any circumstance, including rape, incest, and life endangerment, which is a restriction that no other federal employees face. A new report released Monday, coordinated with a lobbying effort on Capitol Hill, says that returning volunteers see this policy as “punitive and unfair” and think it needs to be changed.

Eighteen of the 362 women interviewed for the study (5 percent of female respondents) had a personal experience with abortion while volunteering, and 32 women (9 percent) had been sexually assaulted during their time of service. The majority of women who had abortions only learned about the no-exceptions policy after they became pregnant, and 97 percent of respondents strongly disagreed with the policy as it currently stands.

Christine Carcano shared her experience with becoming pregnant from rape during her Peace Corps service in Peru with RH Reality Check via email. She didn’t want to tell her parents about the attack, she said, because “I did not want my service tarnished by this experience in anyone’s eyes.” So she turned to a fellow volunteer, who told his mother. The mother sent Carcano a $500 check with a note saying, “Money should be the last thing you have to worry about right now.”

Carcano, like many Peace Corps volunteers, subsisted on a meager stipend. She only made $300 per month, and the procedure would cost at least $500. The check from her friend’s mother allowed Carcano to have the procedure, she said, but it limited her options medically—she could only afford the smallest amount of anesthesia possible. Her doctors said it would be OK, but she said no injury she’s had in life compares to the “searing pain” of that procedure.

“I felt it in every part of my body,” she said. “What was already a traumatic experience was made all the more painful due directly to my financial limitations.” The entire ordeal was “blow after blow after blow,” she said, from being raped, to not wanting to tell anyone about it, to being forced to do so after testing positive for a sexually transmitted disease, to finding out she was pregnant, and finally being told that her medical coverage would include travel and other costs, but not an abortion itself.

“The current policy in the simplest terms is unjust,” Carcano said.

She said she doesn’t blame the Peace Corps because their hands were tied, but she urges the U.S. government to do the right thing by its volunteers. “By allowing a Peace Corps Volunteer’s employer to aid financially in these drastic and traumatizing experiences, the government would be proving how much they value our lives and our future.”

The problems Carcano had—not making enough to cover the abortion out of pocket, losing more confidentiality than she bargained for, compounding an existing trauma—are similar to those experienced by other returning volunteers who were interviewed for the new report. Women also reported being given no information other than a phone book when they asked about where they could obtain an abortion.

Because of the Peace Corps’ policy requiring women to be medically evacuated to Washington, D.C., after they are determined to be pregnant, many volunteers also reported concerns with confidentiality or with finishing their projects. Once evacuated to D.C., if the volunteer chooses to have an abortion, she has to pay for the procedure herself and remain in D.C. for about a month before being medically cleared to go back to her host country.

“If somebody leaves for, you know, a month or two, and goes to DC and comes back … it just doesn’t take much of a stretch of the imagination to kind of figure out what it was that happened to that Volunteer,” one participant noted in the study.

Given these hurdles, some volunteers seek an often-illegal abortion in their host country. Most volunteers who’d had an abortion also reported going through the procedure alone, either because they didn’t want to tell family members or because people in their support networks could not come to D.C.

Almost all of the study participants disagreed with the current policy, and a majority think it should be expanded to cover all abortions, not just those needed for dangerous or rape-induced pregnancies. The study includes a word cloud showing the most common responses volunteers had to the current policy; those words included “shocking,” “unfair,” “wrong,” “appalling,” and “bullshit.”

To make matters worse, according to the report, no other group that receives health care from the federal government—like Medicaid recipients, federal employees and their dependents, women in federal prisons, and even employees of the Peace Corps—faces the same restrictions on abortion coverage that Peace Corps volunteers do.

To remedy what is seen as a wrong-headed policy, returned volunteers and survivors of sexual assault are lobbying Congress this week to pass the Peace Corps Equity Act, slated to be introduced by Sen. Jeanne Shaheen (D-NH) and Rep. Nita Lowey (D-NY). President Obama has also included a fix to include coverage for cases of rape, incest, and life endangerment for Peace Corps volunteers in his annual budget proposal for the 2015 fiscal year.

The study’s authors also recommended better informing volunteers about the policy ahead of time and about available abortion providers; letting volunteers draw from their $7,500 readjustment allowance that they get upon return to the United States in order to pay for an abortion; finding ways to expand volunteers’ access to safe abortion care in their host countries, either with or without Peace Corps participation; and ensuring reliable access to contraceptive care.

“Extending basic reproductive health care services to female Peace Corps volunteers is long overdue,” said Sen. Shaheen in a statement. “Peace Corps Volunteers face inherent risks living and working abroad. There’s no reason they should be denied standard health care services offered to most women with federal health care coverage.”

]]>http://rhrealitycheck.org/article/2014/05/06/report-total-abortion-coverage-ban-hurts-peace-corps-volunteers/feed/6The “No Life-Saving Abortions” Lie, and Why It Persistshttp://rhrealitycheck.org/article/2012/10/23/no-life-saving-abortions-lie-and-why-it-persists/?utm_source=rss&utm_medium=rss&utm_campaign=no-life-saving-abortions-lie-and-why-it-persists
http://rhrealitycheck.org/article/2012/10/23/no-life-saving-abortions-lie-and-why-it-persists/#commentsTue, 23 Oct 2012 08:08:46 +0000When Joe Walsh argued that "new technology" made abortions to save a woman's life unnecessary, he was parroting a dangerous view that could put millions of lives in jeopardy.

]]>Illinois Congressman Joe Walsh may have shocked pundits last week when he claimed abortion is never necessary to save a woman’s life, but where exactly did his get the idea that “new technology and advances in science” have made this groundbreaking new theory possible? From Ireland, where a September symposium gathered to present their medical hypothesis that there is no circumstance in which a woman’s health is saved by terminating a pregnancy.

The International Symposium on Excellence in Maternal Healthcare, which met in Dublin, Ireland in advance of the growing discussion on whether Ireland should allow more access for women to obtain abortions when their health is at risk, brought together medical professionals from across the country to advocate on behalf of “management” techniques that could allegedly be put in place in order to prevent a woman from seeking a termination on the grounds that being pregnant endangered her health. A press release following the conclusion of the conference read:

Dr EoghandeFaoite of the organizing committee for the symposium said that the research presented provided clear evidence that best practice medical care for pregnant women does not involve abortion.

“It was fascinating to learn about new therapies involving the safe delivery of chemotherapy during pregnancy and the exciting field of in-utero fetal surgery” he said. “When discussing matters of pregnancy and medicine it is vital that the voices of the real experts, those that actually care for pregnant women, be heard.”

“This Symposium puts an end to the false argument that Ireland needs abortion to treat women, and it was encouraging to hear the international speakers commend Ireland’s high standards of maternal healthcare and low rates of maternal mortality,” he added.

“The Dublin Declaration stating that abortion is not medically necessary was a statement of fact agreed by medical experts and reflecting best medical practice in maternal healthcare,” stated the medical advisor to the Life Institute, Dr Seán Ó Domhnaill.

“This is a globally significant outcome, which shows abortion has no place in treating women and their unborn children,” he affirmed.

The conference focused on the anti-choice position that when it comes to treating pregnancies with maternal complications, not only are both mother and fetus or embryo “patients” but that the unborn patient’s “life” takes precedent over the health of the woman carrying it.

Can both “lives” be saved? Possibly, in some cases. It’s the amount of threat to a woman’s health in the process that is an acceptable risk that becomes the real gamble, and it’s a sacrifice that anti-choice medical professionals seem eager to force them into making. The most well-known trade off is the idea of the “pro-life” way to deal with an ectopic pregnancy. In the “no direct abortions ever” community, an ectopic should never be treated with a termination, traditionally an injection of methotrexate before the pregnancy progresses far enough to damage a fallopian tube. That is considered a direct abortion, where as anti-choice physicians recommend waiting to see if you miscarry naturally first (a possible outcome for all pregnancies but no more likely than any other time). The reason, besides rejection of ever terminating a pregnancy? Some physicians worry that the extremely rare case of a “hidden” twin that is yet undetected on an ultrasound could be lost in the process as well.

Holding off surgery and watchful waiting in this case might have resulted in spontaneous resolution of the tubal pregnancy or would have required surgical removal of the tubal pregnancy when the embryo was likely to be dead, but in both cases the uterine pregnancy would probably have survived. Unfortunately, the chemical abortion killed both babies, much to the dismay of this young pro-life woman.

It is only ethical to remove the tubal pregnancy if spontaneous resolution does not occur after watchful waiting and if the physician is 100% certain that there are no twins. At this point, the embryo in the fallopian tube is likely to be dead and, even if not, the death is unavoidable and unintentional, and the procedure is necessary to save the life of the mother.

What about abortion in the case of a woman with cancer? The current advocacy is that the woman should simply wait and begin chemotherapy and treatment after the first trimester to reduce the risk to the fetus. It’s a choice that women and their doctors should weigh the risks and advantages of on a case by case basis. But to take it away from them all together, especially in cases of extremely advanced or aggressive illness? That is exactly what a “no exceptions” abortion ban would do. We saw what that meant in Columbia, where a teen was forced to wait until 13 weeks to receive treatment. Both the girl and the fetus she was carrying were lost as a result.

It’s no wonder that The American College of Obstetricians and Gynecologists are demanding that politicians “Get out of our exam rooms.”

Contrary to the inaccurate statements made yesterday by Rep. Joe Walsh (R-IL), abortions are necessary in a number of circumstances to save the life of a woman or to preserve her health. Unfortunately, pregnancy is not a risk-free life event, particularly for many women with chronic medical conditions. Despite all of our medical advances, more than 600 women die each year from pregnancy and childbirth-related reasons right here in the US. In fact, many more women would die each year if they did not have access to abortion to protect their health or to save their lives.

Unfortunately, inaccurately stating that abortions are “never necessary” to save the life or protect the health of a pregnant woman or girl isn’t the only danger of anti-choice legislators practicing medicine in abortion politics. When it comes to actually putting an exception into practice, the law puts medical professionals in nearly as much risk as their patients.

In researching my first book this summer, I had the opportunity to talk to a variety of different providers in multiple states, all with different rules when it comes to abortion access. All of them had the same uneasiness when it came to exceptions based on medical diagnosis, as vague bills written by those who aren’t physicians make it unclear exactly when an abortion is acceptable, or when a provider could be accused of breaking the law. Most exceptions are being written only to include cases where not aborting could “result in her death or in substantial and irreversible impairment of a major bodily function.” As a result, doctors are being asked to decide at what point they must allow a woman to put her life at risk before they can justify performing an abortion without a potential arrest.

One Wisconsin provider discussed the attempt to decide when exactly an abortion can be performed as a decision of exactly how endangered her life had to be. Was a 20 percent likelihood of the patient dying enough, or did he have to wait until actual organs began to fail before he could guarantee a “justified” abortion? In both cases, a fetus prior to viability would still die, but in the former case the patient could be saved and regain her health, while in the latter her recovery may be more drawn out or even impossible.

When an abortion is allowed under these unclear medical exceptions is nearly impossible to ascertain. Just as disturbing is the way that the laws mandate how an abortion is to be performed. In Georgia, where the state legislature nearly deadlocked on a “no exceptions” 20 week post conception ban, a last-minute compromise granted a woman the ability to get an abortion if the pregnancy was “medically futile.”

The exception is extremely narrow, but the way an abortion could be performed is even more troublesome. The bill mandated that termination could only be done in a way which:

[I]n reasonable medical judgment, provides the best opportunity for the unborn child to survive unless, in reasonable medical judgment, termination of the pregnancy in that manner would pose a greater risk either of the death of the pregnant woman or of the substantial and irreversible physical impairment of a major bodily function of the pregnant woman than would another available method.

The end result? Medically futile pregnancies—designated as such because a doctor has confirmed that the fetus would have no ability to survive meaningfully outside of the womb—would be terminated in a way most inclined to produce a live birth. No drugs could be given that would stop the heart before a process is undergone. It would be likely that in the case of those fetuses on the edge of viability or a few weeks beyond, the woman carrying the fetus would be forced to undergo a cesarean section in order to facilitate a live birth.

It’s that argument that Ruth Cline, the opponent of Rep. Doug McKillip, the sponsor of the Georgia bill, has been using on the campaign trail as a reason for voting against him in November. McKillip said he was simply writing legislation to ensure, “You deliver the baby in the way that’s most likely to save both lives,” despite the fact that the fetus has already been ruled unlikely to live much beyond delivery, and that the woman would be likely to need future operations for any subsequent pregnancies as a result.

What McKillip and other lawmakers who have proposed this “best opportunity for the unborn child to survive” language have done is essentially removed exceptions all together. An “abortion” that is really just the delivery of a baby that can’t survive outside the womb by any means necessary to preserve the life of the fetus is no different than the decision to force a woman not to end an ectopic pregnancy until her tube ruptures and only then remove embryo as part of the procedure. These absolutely extremist exceptions exist not out of some form of necessity or compassion but to create medical protocol that enforces their notion that direct abortion is never a needed procedure.

McKillip, Walsh, and other anti-choice extremists are willing to put women’s health — both her immediate health and her future health and fertility—in jeopardy in order to adhere to an extremist belief that there is never a need for abortion. It isn’t “pro-life” to force women to risk their lives on behalf of a child that may or may not survive, or to make her put herself into physical danger before she is allowed to terminate a pregnancy. If politicians were truly interested in growing families, they would be just as anxious to preserve maternal health in order for women to be able to give birth to larger families rather than put her life at risk on behalf of a child that isn’t likely to survive.

Worried that if anti-choice politicians had their way, you might end up in jail for procuring an abortion? Well, you can rest assured on one thing… at least for now, New York Representative Peter King only wants to throw doctors in jail.

AMYGOODMAN: So, should a woman who wants to have abortion be criminalized? Should she be charged with murder?

REP. PETERKING: No, it would be the doctor, not the woman.

AMYGOODMAN: The doctor?

REP. PETERKING: Absolutely, yeah.

AMYGOODMAN: So the doctor should be thrown in jail.

REP. PETERKING: Well, it should be a law. Again, each state can decide how they want to—you know, what sanctions they would be. But obviously, if you have a law and somebody violates it, there have to be penalties, whether it’s civil or whatever. Actually, I’ve got to go in a second.

AMYGOODMAN: Do you think Paul Ryan’s position, which you share, will help you realize that goal eventually in America?

REP. PETERKING: Well, obviously, you elect someone who you want to pursue your goal. But it’s certainly not going to happen in the next four years, that’s for sure.

King says it won’t happen anytime in the next four years, but if you look at Wisconsin, where doctors are afraid to offer medication abortions because they aren’t sure how to do so without being charged with a felony, we’re already there.